monitoring social care

[TinaT]

How can we ensure that there is proper regulation of what goes on in private care homes? This is an issue very close to my heart. I personally have no experience of relatives in private care home settings. My Ken is in a local authority home and when I did have a very serious complaint, I can say with my hand on my heart, that it was properly dealt with in every respect. I didn't entirely agree with the findings of the enquiry but can say that the complaint was dealt with in a fair and transparent manner.

I have been a member of my local LINKs organisation, members working in a purely voluntary capacity which tries to voice the needs of local people in relation to all health and social care issues. Part of the duties of this organisation is to inspect local care homes and send a report to both the local authority and the CQC.

Without any help from either the CQC or the Local Authority, we volunteers had to train ourselves for inspection of care homes. This took many months as each and every member of the volunteer inspection team visited a local care home to observe and understand what professional caring within a care home situation entails prior to the official inspection duty. This was all arranged and carried out as I say by local members of the public.

The volunteer team officially visited a care home at the end of last year. The particlular care home inspected had been chosen because we had good knowledge that the care home had areas which had caused some concern within the local community.

The report we complied was sent to the two authorities, CQC and Local Authority being the two bodies to whom we had to report our findings. We had used the CQC guidlines of 'Essential Standards' to both inspect and compile our report. There were some serious areas of concern which were highlighted in this report.

We were then informed by the CQC that our report, so painstakingly complied and involving months of preparatory work, would be filed and if there were three independant complaints made in the next year or so, then the CQC would inspect this care home. So our report was to be put 'on file'. The Local Authority promised us they would pass on our report to their commissioning authority but we were given no idea of how they would use the report.

What little feedback we did have from the CQC was very negative and despite our asking them, they refused to come and discuss anything with us. So much for local involvement with local people! I have now personally given up trying to make a difference. In future I will, as most people seem to do, concentrate just on me and mine. I see little use in doing anything otherwise from my own experience of trying to make a difference. I see little evidence that official bodies, including the current government, take any local voluntary work into any of their policy making. Are local voluntary groups just being 'used and abused' I wonder?

Local involvement, which should be the cornerstone of improving care for local people is a vital resource, one which seems to be scantly reguarded.

I wonder what effect the Alzhimer Society has on the quality of care or indeed the national monitoring of care within a care home setting? Or is this not within the Alzheimer Society remit? I wonder why we continually, year after year get TV documentaries, or radio programmes or news bulletins, highlighting the latest deplorable, heartbreaking scandle within social care?

The CQC is not a reliable monitoring body and Local Authority monitoring seems to also fail. Now the Alzheimer Society have reformed and no longer have active local volunteeers, is there anywhere either within any charity organisations, or within public bodies where there is any proper monitoring taking place any more?

TinaT

 

[jimbo 111]

Tina
you are voicing the frustration of so many people who are striving to
move on from all the official reports that are churned out like graffiti, and never seem to resolve the problems
Your experience adds insult to the injury , this goverment has made great play on the need for local involvement, then allows all these official bodies to sit on things , and make people like you , say what's the use.
I would like to send your post to my MP ,as a form of protest, but before doing so I would like to know if it is OK with you
jimbo 111

 

[TinaT]

You are welcome to use my experience Jim. I've sent an almost identical copy of my post on TP to the Secretary of State at this holding e mail address: http://www.dh.gov.uk/en/ContactUs/DH_066319#3

Apparently it does go from here to Andrew Langsley himself but we will see if I get a reply.

xxTinaT

 

[Saffie]

My husband is about to enter a LA nursing home - through choice, as he will be self-funding for a few months. I have been assured by my local County councillor that the LA homes are inspected regularly, especially if a fault is found at any stage, by elected Adult Services representative on the council (one happens to be him) and that any complaint is followed up immediately. I'm hoping that this is so as i am putting my faith into this assumption.

 

[Mr_Angry]

Lateral thinking

When this Government claims that we are all must play our part in 'the big society' the actions of LINK and other voluntary groups should be encouraged rather than silenced.

In social care as in many other areas the role of regulators is called into question. What is the point of regulators if they can bark but can not bite. Sadly even barking appears to be beyond some of them.

I notice that the Alzheimer Society is now funded by Santander. I hope they encourage the Society to challenge as well as support. It is good to see a bank helping the society in their cause and as 'bash the bankers' is the term now associated with banks a bit of good publicity goes a long way to improve a banks image as well.

The key thing to know about banks is that they have large City shareholders and some also have large investments in care homes, Southern Cross being one, which itself has large shareholders some of whom may be shareholders of the bank. What a complex web the City weaves. As a 'service user' of Southern Cross your voice may not be heard but as a shareholder your voice and vote can be used to raise issues and one thing the PR department of PLC's don't like is an activist shareholder and the possibility of bad publicity.

Making complaints to regulators, local authorities, private care homes etc does appear to be a waste of time how ever as large sections of social care are now run for profit making complaints to the directors of a PLC or City investors with financial stakes in a care home could be an alternative. You don't need City links to find out who owns the mortgage on a care home be it Southern Cross or smaller operators.

 

[jenniferpa]

I notice that the Alzheimer Society is now funded by Santander. I hope they encourage the Society to challenge as well as support. It is good to see a bank helping the society in their cause and as 'bash the bankers' is the term now associated with banks a bit of good publicity goes a long way to improve a banks image as well.

FYI - Just for the sake of accuracy, I should point out that Santander is now funding Talking Point, which is rather different. http://www.alzheimers.org.uk/santander

AS gets funding from a wide range of sources.

 

[JPG1]

Tina,

I’ve read your thread about monitoring social care, and jimbo’s and saffie’s replies to you are a great starting point for discussion and debate. Surprise, surprise! I’ve got more than a few suggestions to offer, constructively and positively. If it’s ok with you, I’d like to think more before posting thoughts, as I’m sure others are also pondering before posting.

In the meantime, I’d just like to ask whether you would allow local authority care homes to sit alongside private care homes in your question as to how we all could contribute to your ‘monitoring of social care’ discussion.

And can that also include domiciliary/homecare services? And sheltered housing/extra-care sheltered housing? They all come under ‘social care’ with needs for monitoring, so that may open your thread to others who’ve got experience of homecare, or sheltered housing, and then later care home care. The normally average progression from home to care home care.

Or are you restricting your research questions to privately-owned care homes?

A starter from me would be that the ongoing monitoring of any care home must not depend on whether it is ‘owned and run’ by a local authority, or whether it is ‘owned and run’ by a private care provider. Because really, there’s no difference from conception through commissioning to delivery.

Each and every care home sited/built/positioned in each and every local authority should go through the local authority 'approval and quality monitoring' process. The monitoring must and should be reliable, regardless.

Most/many/almost all privately owned care homes receive local authority funding to support their enterprise, if only because the majority also receive local-authority-funded residents. There are very few local authority owned care homes now - the great majority are privately owned - but the majority of privately owned care homes are heavily funded by local authorites, so for those who are still able to find a LA owned and run care home, they will need guarantees of quality monitoring too.

It shouldn’t matter who owns and is registered with the CQC to run a care home. The quality of care must meet the top standards that a civilised and rich society demands and accepts without question, but only if those standards meet the requirements.

More as and when.

PS. Just seen mention of Santander funding Talking Point, so thought this might be of interest -

http://www.guardian.co.uk/money/2011/jun/04/santander-nightmare

If Santander can't find the way to care enough to train its own staff to help an 84-year old who is dealing with the death of her husband, it makes you wonder about the ability of Santander to care about others. In the best interests of those with dementia, rather than in the best interests of Santander's self-promotion.

 

[TinaT]

My post is about social care monitoring in all the forms of social care adults use. LINKs organisations are authorised to enter, view and report on all the varieties of social care with the exception of children under the age of 18; a further exception is any care provided in a person’s own home. LINKs are not allowed to enter a private home unless invited to do so.

My own recent experience of the CQC’s disregard of an impartial, locally based report on a care home was given as an example of the way in which local information is disregarded by this government body. I have no experience of presenting reports on hospitals, young mentally handicapped premises, etc., etc. but these are also within the remit of LINKs.

It is hardly surprising that the CQC take this complacent approach as there seems to be no transparency or public accountability built into their structure. I’m afraid they will continue to be inefficient and ineffective until there is some accountability and a proper, open and transparent method of dealing with the information they receive.

Local authorities are the major funders of private care homes and therefore have a vested interest in ensuring that their funding is being used properly. Hopefully the commissioning arm of any local authority will use any local information but again, there is no open and transparent path for such information. Paradoxically, they are also the major factor in driving pricing of care home placements to the bare minimum and so in this respect there seems to be somewhat of a dichotomy.

At least local authorities are accountable to local people and we have the power to challenge local councillors and have questions raised in appropriate local council committee meetings. The public also have the power to vote out councillors who fail to ensure that the needs of local people are being met. Sadly not many local people use this power as often there is a turn out of less than 30% in local elections.

My main worry is that the CQC, the body responsible for monitoring standards of national care is failing so badly. The CQC will also have the additional responsibility of monitoring all GP consortiums. God help us if we need to complain about GP’s to them given their past and present track record.

TinaT

 

[TinaT]

This is the reply I've just received from the Department of Health in response to my letter to the secretary of state.



Thank you for your correspondence of 6 June to Andrew Lansley about social care regulation. I have been asked to reply on Mr Lansley’s behalf.

I was sorry to read of your husband’s ill health but I was pleased to read of your satisfaction with his care. I can appreciate the strength of feeling behind your desire for people in care homes to have access to the highest quality of care and support.

I can also assure you that ministers are aware of the valuable work done by volunteers across the social care sector and recognise the importance of local involvement.

As you know, the Care Quality Commission (CQC) is the independent regulator of health and adult social care providers in England, with responsibility for providing assurance of essential levels of safety and quality.

Under the Health and Social Care Act 2008, all providers of regulated activities, including NHS and independent providers, have to register with the CQC and meet a set of registration requirements. The 16 registration requirements reflect the essential levels of safety and quality of care that people should be able to expect, and are built around the main risks inherent in the provision of health and adult social care services.

Unlike its predecessors, the CQC does not have responsibility for individual complaints and will not usually intervene in individual incidents. Each provider is required to have an effective system in place for dealing with complaints. However, the CQC can consider any concerns raised with it, including by people who use services or staff, regarding the provision of health and adult social care services and will add them to the intelligence it gathers about providers on its quality and risk profiles, which can act as a prompt for regulatory action.

I note your concerns that local opinion is not taken into account by the CQC. The CQC’s responsive system of regulation brings together a wide range of information from people who use the services, inspections, data sets (for example, mortality and infection rates) and information from partner bodies. This is all contained in a quality and risk profile for each provider. This is constantly updated and acts as a prompt for action.

You may also be interested to know that the CQC recently recruited ‘experts by experience’, older people who have experience of health and social care and who can give the patient perspective, to join teams led by senior nurses and matrons to carry out a series of unannounced inspections of hospitals and care homes.

On the issue of the CQC’s involvement with local voluntary organisations, I should explain that, as an independent regulator, responsibility for investigating complaints about the CQC rest with the CQC itself. You may therefore wish to make a formal complaint and details of how to do so can be found on the CQC’s website at:

http://www.cqc.org.uk/contactus/howtoraiseaconcernorcomplaint/howtocomplainaboutcqc.cfm


So from the contents of the above letter, the CQC no longer has the power to deal with individual complaints. Individual complaints have to be made to the company themselves. I'm quite sure that individual complainers have always complained directly to the company concerned but always in the past they had the option of having their complaints at the very least being investigated by the CQC. What happens if a company ignore your compaints or 'shelves' or denies them? Who do we go to to get help nowadays?

TinaT
TinaT

 

[Grannie G]

I should explain that, as an independent regulator, responsibility for investigating complaints about the CQC rest with the CQC itself.

A bit like MPs investigating their own expenses claims and Bankers investigating their bonuses.

 

[sunny]

Mr. Angry

I would certainly agree with your piece:-

"In social care as in many other areas the role of regulators is called into question. What is the point of regulators if they can bark but can not bite. Sadly even barking appears to be beyond some of them"

Oh so true!

It seems its all grit but no pearl particularly in the care industry.

 

[TinaT]

How can we be living in a democracy when such an important matter as changing the regulation of Care Homes and investigation of complaints have been been allowed to happen without even a public murmur? I suspect that most of us, myself included, had no idea that this had taken place behind our backs.

How has the methods of protecting our voiceless and vulnerable members been weakened in this way without our even knowing it?

We are the suffers and carers of this terrible disease. I wonder how many of us were included on the 'standing committee' or whatever body it was that decided to reduce even the feeble protection the predecessors of the CQC were offering?

TinaT

 

[danny]

Tina, I received an email of concern from the CQC re our dom. care service.

It was administration related,but, nevertheless, they had forwarded the concern to me and wanted to know what my findings etc where.

If they were following up this concern surely they should be investigating complaints/concerns re care standards.

I`m as confused as every one else.

 

[TinaT]

Hi Danny, indeed confusing!! As you say it was an administrative concern which the CQC contacted you about, it seems pretty strange to me too that this area can elicit a dialogue with the CQC but a 'hands on' caring issue cannot.

I just wish that the government would 'listen' to us as it seems to have done regarding the mistakes made in the proposed health changes. How angry I feel that we are just not listened to and that the response made to me clearly indicated that my concerns did not in the least concern the Dept. of Health or the Minister for Social Care.

xxTinaT

 

[jimbo 111]

.

I just wish that the government would 'listen' to us as it seems to have done regarding the mistakes made in the proposed health changes. How angry I feel that we are just not listened to and that the response made to me clearly indicated that my concerns did not in the least concern the Dept. of Health or the Minister for Social Care.

xxTinaT

Grinding my teeth at the frustrationyou must feel with such a negative response
Is there any possibility that we could open a petition to the government on the Government No 10 partitions
A carefully worded petition ( or partitions ) from the thousands of people quoted as being members of TP would surely give us a bit more individual rather than corporate publicity and help to bring our feelings and frustrations to a wider audience than TP
jimbo 111

 

[TinaT]

If you can give us the link Jim, then I will use it and anyone can add their name who wants to do so.

xxTinaT

 

[jimbo 111]

If you can give us the link Jim, then I will use it and anyone can add their name who wants to do so.

xxTinaT

Hello Tina
this is the link

petitions.number10.gov.uk

(I could not get it on a direct link but I know the above will connect you via Google)

I have tried search petitions and could not find any refering to Alzheimers or dementia

jimbo 111

 

[TinaT]

I've drafted the following to be used as an online petition at the website which Jimbo has kindly supplied.

There is deep public concern that current legislation governing the monitoring of social care is inadequate as it does not ensure quality of care given in residential care homes. I ask that the government urgently investigate the level of staffing, training and resources for such establishments and sets minimum legal standards which apply to every care home in the country. I also ask that the CQC which is the government body responsible for complaints procedures is given legal powers to ensure that such minimum standards are met and also has the power to deal with relatives’ complaints within a set time limit and in a clear, transparent and proper manner.

Name:

E mail address:


I would be so glad if other TP members would add their comments and suggestions so that it reflects the concerns of so many carers.

TinaT

 

[TinaT]

I'm posting in the hope that as this will go onto the new posts section of the forum, more people will see it

TinaT

 

[danny]

This may be of interest.
http://www.bbc.co.uk/news/uk-england-cornwall-13853433